Dr. Anthony Porto, medical director, Yale New Haven Children’s Hospital Celiac Program is often asked many questions about celiac disease, gluten sensitivity and the gluten-free diet. Here are 5 important facts that you should consider if you think you or your child may have a problem digesting gluten.
There are 3 recognized gluten related disorders. Celiac disease, wheat allergy and gluten sensitivity are the different types of conditions associated with gluten intolerance. Celiac disease occurs in approximately 1% of the population, wheat allergy in 0.1%, and gluten sensitivity between 0.3 – 8%. Both celiac disease and wheat allergy have definitive screening and diagnostic tests while gluten sensitivity depends on symptomatic improvement after initiation of a gluten free diet.
Symptoms of celiac disease can vary. Younger children typically have gastrointestinal symptoms, such as vomiting, abdominal pain or bloating, poor weight gain, constipation and/or diarrhea. While older kids have non-gastrointestinal symptoms and present with symptoms including lower height than expected, rashes and iron-deficiency that is not responsive to supplementation. Children who are considered high-risk for celiac disease are often asymptomatic: Celiac disease is usually discovered with routine screening of these high risk groups including Down’s syndrome, type I Diabetes and those with immediate family who have celiac disease.
Continue a gluten containing diet for now. The most common screening test for celiac disease is a blood test. It is important to continue a gluten-free diet to make sure the results require that you be eating gluten at the time you are tested. So before you remove bread from your child’s diet, please speak to your physician to discuss testing.
It’s important to differentiate between the gluten sensitivity and celiac disease: Celiac disease is immune mediated therefore careful adherence to a gluten-free diet is important to prevent intestinal inflammation and associated long-term complications including nutritional and bone issues. Gluten sensitivity is not associated with long term complications or intestinal inflammation. Since the only current treatment for celiac disease is a gluten free diet, it is important to know what type of gluten intolerance your child may have (if any) because if it is celiac disease, this is a life-long diet change.
The gluten-free diet may not be a complete diet. Though a gluten-free diet can be healthy. It is important to work with a dietitian who can evaluate vitamin and/or mineral deficiencies, recommend diet changes and potential vitamin supplementation. Also, gluten-free processed foods tend to be higher in fat and lower in protein so it is best to eat naturally gluten-free foods including beans, meat, fruits and vegetables.
The Pediatric Specialty Center in Greenwich offers children and their families convenient access to Yale New Haven Children’s Hospital pediatric subspecialists in a range of pediatric medical and surgical specialties. Yale New Haven Children’s Hospital is ranked nationally amongst the best children’s hospitals in gastroenterology by U.S. News and World Report. Our pediatric gastroenterologists are located nearby in Greenwich, Norwalk and Trumbull. To make an appointment, call 203-785-4081 or to learn more visit https://goo.gl/9ZTX9N
